Department of Gynecologic Surgery, Rochester, MN, USA.
Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
Ann Oncol. 2010 Sep;21(9):1772-1778. doi: 10.1093/annonc/mdq025. Epub 2010 Feb 5.
The objective of the study was to evaluate completion rates and toxic effects of an i.p. chemotherapy regimen in a cross-section of nonselected patients with ovarian cancer (OC).
All patients with stage IIIC OC consecutively operated at our institution from January 2006 to December 2007 were prospectively collected and analyzed.
Eighty-nine patients with stage IIIC OC optimally debulked were evaluated for this study. An i.p. port was primarily placed in 53 of 89 (60%), and i.p. chemotherapy was recommended in 55 patients. Reasons for not recommending i.p. chemotherapy in patients optimally debulked included postoperative complications (n = 7: 8%), poor nutritional/functional status (n = 5: 6%), and extensive surgery including bowel resection (n = 9: 10%). Thirty-three patients (33/55: 60%) recommended to receive i.p. chemotherapy-initiated i.p. treatment. Fifty-two percent of those beginning i.p. therapy (17/33) received three or more cycles with 36% (12/33) successfully completing six cycles. Reasons for discontinuation included grade 3-4 nephrotoxicity in 3 of 21 (14%), febrile neutropenia/sepsis in 3 of 21 (14%), port infection or malfunction in 8 of 21 (38%).
The i.p. chemotherapy regimen used in a consecutive cohort of patients carries could be completed in only a small percentage of patients. Less toxic regimens with higher acceptability should be considered.
本研究旨在评估在非选择性卵巢癌（OC）患者中接受腹腔化疗方案的完成率和毒性作用。
我们前瞻性地收集了 2006 年 1 月至 2007 年 12 月在我院接受手术治疗的所有 IIIC 期 OC 患者，并进行了分析。
共有 89 例 IIIC 期 OC 患者接受了最优的减瘤手术，其中 53 例（60%）患者放置了腹腔内端口，55 例患者推荐接受腹腔内化疗。在接受最优减瘤术的患者中，不推荐腹腔内化疗的原因包括术后并发症（n=7：8%）、营养/功能状态差（n=5：6%）和包括肠切除术在内的广泛手术（n=9：10%）。33 例（55 例患者中的 33 例：60%）患者推荐接受腹腔内化疗，其中 33 例患者中有 17 例（17/33）开始接受腹腔内治疗。接受腹腔内治疗的患者中有 52%（17/33）完成了 3 个或更多周期，其中 36%（12/33）成功完成了 6 个周期。停药的原因包括 3 例（21 例中的 3 例）出现 3-4 级肾毒性、3 例（21 例中的 3 例）出现发热性中性粒细胞减少/败血症、8 例（21 例中的 8 例）出现端口感染或功能障碍。
在连续队列的患者中使用的腹腔内化疗方案只有一小部分患者能够完成。应考虑使用毒性更小、接受度更高的方案。
